Global influence

The following article contains the complete responses from each individual interviewed for the June cover story of Counseling Today. This version is longer than what ran in the magazine.

To American Counseling Association President Bradley T. Erford, the globalization of counseling is not about creating a mirror image of the profession as it is practiced here at home. In fact, Erford thinks counseling’s global spread offers valuable opportunities for professional counselors in the United States to absorb new techniques and new ways of thinking about counseling from every corner of the earth.

“We have much to learn from how counseling is evolving in other cultures and nations,” says Erford, a professor in the school counseling program at Loyola University Maryland. “Regardless of where we live and practice, professional counselors share a core identity, and that identity is modified and molded by culture. Because all counseling is multicultural counseling, some of the ‘best practices’ we use in the United States may miss the mark when counseling clients and students from diverse cultures. We have much to learn from counseling professionals working all around the world who are using diverse and culturally sensitive approaches to build strong connections and create therapeutic changes that help promote mental health and wellness.”

Although counseling is comparatively new in the mental health arena, it is a fast-growing profession globally, says ACA President-Elect Cirecie West-Olatunji. “As international students acquire their training in U.S. programs, offered abroad and stateside, they are taking a message back to their home countries about the value of counseling in relation to the needs of their nations,” says West-Olatunji, associate professor and director of the counseling program and the Center for Traumatic Stress Research at the University of Cincinnati. “Many of these countries are developing counseling as a discipline and have integrated an understanding of social justice and advocacy as core values. Others have woven in culture-centered counseling concepts that honor religious and ethnic differences. Counselors in the U.S. can learn a lot by exchanging [ideas] with their counterparts in other regions of the world.”

Counseling is happening in some form in nearly every nation around the world, Erford says. In fact, counseling is even the primary mental health discipline in some nations, he says. As an example, he points out that counselors in Malaysia have licensure, while psychologists and social workers do not.

As counseling spreads across the globe, Erford notes the efforts of ACA and its colleagues to be involved in the growth process. For instance, ACA is exploring the idea of offering a low-cost electronic membership option to international counselors to make professional development and networking affordable to those in developing nations. In addition, Erford points out, the Council for Accreditation of Counseling and Related Educational Programs has developed the International Registry of Counsellor Education Programs, while NBCC (National Board for Certified Counselors) International is collaborating with a number of countries to develop licensing and certification mechanisms to meet diverse needs.

West-Olatunji knows from personal experience how beneficial it can be to interact with international colleagues and learn more about how counseling is practiced in other nations. “Having conducted several international outreach trips and provided consultation in multiple countries to help advance our profession, I have been greatly informed by the philosophical and procedural differences that exist in counseling programs outside of the U.S. In particular, I was amazed to see the use of dance and movement as part of the repertoire of interventions used in South Africa, Romania and India. Additionally, I was intrigued to learn about the infusion of religious and moral values in counseling from a counselor educator in Botswana. I have since incorporated a greater range of nonverbal counseling interventions within my training and research.”

Education, training and experience may vary widely among counselors from country to country, but Erford says the motivation and mission of counselors across the globe is the same: “to help people in intrapersonal and interpersonal anguish adjust to life in a healthier, happier way. Just as we know from outcome research in the United States that one’s license title or position title has little to do with therapeutic success rates, the same is true in other countries. For example, in some countries no college degree is needed to be a counselor; in others, a three-year undergraduate degree makes you license eligible. But what makes you successful is your ability to connect with people, motivate them to change and then facilitate that change using culturally sensitive and respectful strategies. Diverse people require diverse strategies. While counselors from the United States have much to offer, there is so much more we can learn from our international colleagues.”

In that spirit of sharing and learning, we hope the readers of Counseling Today will gain from the perspectives being offered here by 20 of ACA’s international members.

Yukio Fujikura runs a private practice in Yokosuka, Japan.

What is the role and function of a counselor in your country — why and when do clients go to see one?

Most medical doctors heavily depend on psychotropic medications with little time to listen to their clients. To make up for this, many mental health clinics and hospitals have a counseling room in which “rinsho shinrishi,” Japanese clinical psychologists who graduate from two-year programs, are working as a counselor. Without appropriate training as a school counselor, these rincho shinrishi also work for public schools as a school counselor. They typically work for some schools as a part-timer, four to eight hours a week for each school. On the other hand, we have many private practitioners in town who call themselves “counselor,” who haven’t got a formal training or credentials. Many Buddhist monks also play the role of the counselor in a counseling room in their temples. In short, it seems that most Japanese including politicians and government officials just see counselors as a quick and easy fix for increasing demand for mental health services in Japan.

What would you most want someone reading this article to know about counseling in your country?

For most Japanese, there are no differences between counselors and clinical psychologists. To be a “rinsho shinrishi” (clinical psychologist), however, you need to know how to use and interpret [a] Rorschach test. The problem is that more and more Japanese came to see that only rinsho shinrishi, with their credential partly and indirectly supported by the Ministry of Education, were legitimate counselors. On the contrary, clinical psychologists working as a part-timer without appropriate training should not be called a school counselor. In my view, we don’t need Rorschach test to help students suffering from bullying and school refusal or to help a couple overcome marital problems.

What obstacles does the profession of counseling face in your country?

The health insurance system in Japan covers no mental health services except those offered by medical doctors. What makes matters worse, it is almost impossible for many counselors to obtain the professional liability insurance. Only “rinsho shinrishi” (clinical psychologists) can obtain the professional liability insurance through their nationwide organization, which is partly supported by the Ministry of Education. Starting my business here in Japan, I thought I should obtain the professional liability insurance. I contacted several insurance companies only to get discouraging replies. Then I emailed HPSO [Healthcare Providers Service Organization], only to find that the insurance coverage they offered was only valid in the U.S. My last resort was to join a local chamber of commerce and industry so that I could obtain an insurance for personal information leakage as a member, which is just for my conscience sake. Another big issue is a lack of availability of supervision, especially for those who studied counseling in the U.S. and now live in Japan.

Klaus Lumma founded and is the senior adviser for the German Institute for Humanistic Psychology. In addition to working in private practice in Germany, Lumma is a part-time counselor with the Faber-Castell Academy, the Catholic University of Aachen and the Gestalt Institute of New Orleans, where he lives six weeks out of the year.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

When I introduce myself as a counselor, I always say that counseling means more than psychotherapy and basically empowers the human capacity for biographical resources. People understand that I deal with the individual lifestyle of my clients and that I encourage them to enlarge the healthy parts of it, by paying solid attention to beloved early recollections and their different creative capacities.

What is the role and function of a counselor in your country — why and when do clients go to see one?

In Germany, the role of a counselor is multifunctional: some are working in the field of childcare and guidance; others are working with parents and couples; some work as school counselors for students; and many, who work in a private counseling studio, offer individual coaching for personal and professional development, mental health counseling and team support.

Where has counseling come from over the past decade in your country and where do you see it headed in the next decade?

Counseling has come from the ongoing need for personal guidance and professional support. For elderly people, it has come from the need for coping with guilt, [particularly] in relation to the history of Germany during the Nazi period of time. In the next decade [of] counseling in Germany, we see counseling heading towards the introduction of resilience work with art-therapeutic tools.

What would you most want someone reading this article to know about counseling in your country?

I would like the readers to know that counseling in Germany has two roots, both of which started in 1913: Alfred Adler’s “individual psychology” from Vienna and Frank Parson’s “personal guidance” concept starting off from Boston. The first has been used for different developments in the field of individual psychodynamic/biographical counseling, the latter for the strategic supervision and guidance in relation to professional issues.

What lesson or idea from your country would you share with counselors in the U.S. — in what way could counseling in the U.S. benefit from the way counseling is in your country?

Let’s share the idea of having biographical thinking and the fine arts being introduced into counseling concepts of the U.S.: including literature, painting, music and three-dimensional work (Gestaltung) in order to make more use of right-hemispheric, analogical learning.

And vice versa, what would you like to see counseling in your country absorb from the way counseling is done in the U.S.?

I have already introduced Frank Parsons’ ideas to German professionals in order to extend psychodynamic work with strategic and systemic interventions.

What obstacles does the profession of counseling face in your country?

Up to now, there is no law on counseling in Germany, only on psychotherapy.

How do you hope to see the counseling profession evolve in your country?

I’d like to hear the Germans use the international term “counseling” instead of the German term “psychosoziale berating,” which is misleading and also too narrow. The counseling profession in Germany would have more political support and power if the different schools of counseling would really unite within one counseling association, using the term counseling as [I] said before.

Buthaina Mohamed Baqir lives in Muscat, Sultanate of Oman, and works in the counseling center at a local university.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

The immediate response is “ Oh, a social worker…so you solve problems?” The Arabic word for this profession is guide, therefore people consider it a profession where people would spill their problems out and [there is] no responsibility for the client to bear.

What is the role and function of a counselor in your country — why and when do clients go to see one?

The graduates of the counseling program in Oman, generally, abide by the American Counseling Association Code of Ethics. They have graduated from programs that follow the ACA Code of Ethics. We have graduates from the U.S., Jordan, Egypt, Oman and perhaps other countries that I am not aware of. The role of counselors and counseling varies according to the awareness level of the people. Some people are seeking counseling as the last resort when circumstances become more and more complicated. The role of counseling is marginalized in that people consider the service secondary to how they can improve their lives. People see counselors mainly for marital/family issues. At the educational institutions, the students seek counseling mainly for academic-related issues and adjustment issues.

What would you most want someone reading this article to know about counseling in your country?

Counseling is still in its infancy stages in the region and it requires a lot of collaborated effort to make it a recognized discipline. The family support is ample in this region, however due to the transitioning period and the generational gaps between the parents and children, counseling is needed at this stage. People still seek family and friends to discuss matters. They may be resolved in a good or otherwise manner, but they are resolved. Counseling as a discipline is still marginalized by many at the various levels of society.

What obstacles does the profession of counseling face in your country?

Awareness about what counseling can offer [and] the variety of counseling services and specialties. [Also], legal protection is not present — where if a client commits suicide, there is not law that would protect us [counselors].

How do you hope to see the counseling profession evolve in your country?

Awareness of the various services that can be offered [and] more involvement from the authorities.

Hildah Mokgolodi works as the principal education officer of guidance and counseling at the Ministry of Education and Skills Development headquarters in Botswana. Mokgolodi directs implementation of the guidance and counseling program in the nation’s primary through senior secondary schools, including some tertiary institutions. Mokgolodi also acts as a referral for teachers on difficult guidance and counseling cases and sees walk-in clients.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

Counselling in Botswana is still a least understood concept. Many still believe anybody can offer counselling and they can counsel themselves, so what is the big deal? There was an influx of non-governmental organisations, which claimed to offer counselling through lay counsellors with the advent of [the] HIV and AIDS pandemic. The lay counsellors would have from a day’s training of HIV and AIDS counselling training to a few weeks. This support was not all that bad, but I think it went against all, if not most, ethical codes. It however highlighted the need for professional counselling in the country. Some who understand it somewhat still think counselling is for individuals who are insane. The biggest challenge is the issue of confidentiality; many individuals do not trust counsellors and it is reflected even more in schools where many learners are usually referred [to counselors] rather than self-referrals. Having said that, those who understand counselling for what it is make full use of it and keep coming back or making referrals where [they] see fit.

What is the role and function of a counselor in your country — why and when do clients go to see one?

The role of counsellors is to help clients adjust so as to function comfortably on a day-to-day [basis]. Most counsellors are in schools to help learners make learning meaningful. Counsellors are called to give support or intervene in crisis situations and some delicate cases.

Where has counseling come from over the past decade in your country and where do you see it headed in the next decade?

Botswana has improved in its training of professional counsellors, with the University of Botswana having its first graduates of master’s degrees a decade ago. The university has started an undergraduate programme. There was an association that was started and died a natural death; however, I am proud to say we now have a strong Couselling Association that, together with relevant stakeholders, is working on having a Counselling Act approved by parliament. The Ministry of Education and Skills Development has increased the number of teachers who have gone for long-term training in counselling or psychology and it is still the intention for the next few years.

What would you most want someone reading this article to know about counseling in your country?

Counselling is a growing profession in Botswana that is picking up speed.

What lesson or idea from your country would you share with counselors in the U.S. — in what way could counseling in the U.S. benefit from the way counseling is in your country?

Couselling is not diagnostic and few labels are put on clients in Botswana, except when done by counselling psychologists. We believe lack of diagnosis reduces stigma, given just going for counselling on its own is stigmatised.

And vice versa, what would you like to see counseling in your country absorb from the way counseling is done in the U.S.?

I wish Botswana would not repeat the same developmental mistakes [the] U.S. made or encountered but learn from their best practices. I like the idea of counselling training starting off as general and, later in the study, one specializing based on their interest and a theory that one finds more appropriate for them. What I liked more was incorporating into the counselling room what works and not only sticking to a single theory but being aware of it.

What obstacles does the profession of counseling face in your country?

Counselling in Botswana has not been professionalized for a long time and it is not regulated by an act [of government]. Therefore, counsellors (professional, para or lay) cannot be held accountable for flouting ethical codes.

Nahla Eltantawy lives in Cairo, Egypt, and runs a private practice with a steady clientele of about 15 clients. Eltantawy received a master’s degree in social work from the University of Pennsylvania.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

If I introduce myself to someone on the street, they probably wouldn’t know what counseling is. Most of them wouldn’t fully understand even after an explanation, while some will think I am either a psychiatrist or a life coach. The concept of counseling doesn’t exist in Egypt; the closest thing would be talking to a religion figure (sheikh) or “wise people.”

What is the role and function of a counselor in your country — why and when do clients go to see one?

There are very few qualified counselors in Egypt; most of them are wives of expats who live and work in their community. Other than that, when people have problems in Egypt they go to one of the following:

1) Psychiatrists: only educated upper middle-class people reach out to them when their problems go out of control, such as kids’ performance in school, depression, anxiety, grief, marital issues, etc. Most of the time psychiatrists prescribe medications.

2) Psychologists who hold a Ph.D.: same population with same issues. Most of the time, the clients don’t know that they are psychologists not psychiatrists because they have “Dr.” before their name. Clients don’t ask and psychologists don’t explain.

3) Life coach (no specific background or qualification): educated upper middle-class women have become addicted lately to “human developing centers” where they attend lectures about energy, how to control your brain, live a happy life, be positive and get one-on-one help for their personal issues.

4) Religion figures (sheikh): upper middle-class people reach [out to] them to discuss their family issues. Everybody else reaches [out to] them for every kind of issue, ranging from kids’ behavior to depression.

5) Relationship counselors (famous writers, actresses, radio/TV hosts, journalists): people call them to talk about their love and marriage troubles.

Where has counseling come from over the past decade in your country and where do you see it headed in the next decade?

Counseling in Egypt started out with wise men/women who give advice and has now turned into psychiatrists sending the message that medication is the answer. However, I believe that with more people getting exposed to the Western culture through education, traveling or even movies, people’s awareness of professional counseling will improve, especially after the American University in Cairo launched their master’s program in therapy.

What would you most want someone reading this article to know about counseling in your country?

The idea that I would like to share with counselors in the U.S. is that after working in both [the] U.S. and Egypt with individuals, couples and families, people are the same everywhere. They are humans. Yes, there are cultural differences the counselor should be aware of and sensitive toward, but they are not barriers. People everywhere share the same fears, insecurities and dreams.

What obstacles does the profession of counseling face in your country?

The obstacles that the profession of counseling is facing in Egypt are:

1) Lack of awareness of the profession.

2) The stigma: most people think that only crazy people or people who cannot deal with or tolerate life hardships go to counselors. Media actually plays a big role in this.

3) Men’s perception of therapy: most men in Egypt perceive counselors as someone who is invading their privacy, so they don’t allow their wives to seek their help. Plus, men think it is a shame to ask outsiders for help since “men know better and can fix their own issues, if they can admit they have any to start with.”

4) Lack of laws that determine certain qualifications or certificates needed to practice the profession.

5) Financial issues: Egypt is a developing country where 40 percent of the population live under [the] poverty line ($2 a day), so very few people can afford to see a counselor; plus we don’t have a health care system that can pay for this kind of service. To add to the mix, the NGOs won’t provide these services, since they have more essential priorities, such as providing the poor with some of the basic needs. Unfortunately, counseling in country like Egypt is considered a “luxury.”

How do you hope to see the counseling profession evolve in your country?

I hope one day counseling can be a structured, regulated, stigma-free, available and affordable service in Egypt.

Becky Aud-Jennison moved from Springfield, Ill., to New Zealand in 2011. She teaches counseling at the local tertiary education institute to second- and third-year students working on their bachelor’s degrees in social services.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

I don’t have a sense that counseling has strong identity in New Zealand. It appears, and this is speaking from a naive newcomer’s position, that although New Zealand is very progressive when it comes to thinking of, and accepting, nontraditional treatments (i.e., energy modalities, acupuncture, various hands-off alternative approaches), counseling and therapy are looked at from a more “medical” or “traditional” perspective. There doesn’t appear to be a norm of going to counselling with issues. Self-referrals appear limited. Most referrals (and word is, those are relatively few) go through a [general practitioner] and are for an average of six sessions. New Zealand counsellors will tell you that they feel their services are not being utilised appropriately. Counselling doesn’t appear to be a service that people are as willing to seek privately in New Zealand as they do in the U.S. The counsellors I meet are very serious about their work and appear very knowledgeable. There seems to be a use gap, as if they are being phased out or were never welcomed in.

What lesson or idea from your country would you share with counselors in the U.S.?

My word to U.S. counselors would be to count your blessings that counseling has accrued the respect and professional regulation to legitimize and advance the practice that it has in America. Don’t assume other countries are more progressive. And don’t lose sight [of] the fact that this profession will not magically stay afloat: support the standards of best practices and regulation that help cement counseling as a permanent fixture in American society.

Is there anything else you’d like to add?

As a country whose mantra is “no worries,” New Zealand is very perplexed about their very high suicide rate. With the divisive nature of services here — mental health, AOD, psychotherapy, psychologists and counselling (and lack thereof) and the lack of a societal norm for getting help (which, in turn, increases stigma) — I find it mindboggling that the lack of places for people feeling depressed and desperate has not been addressed. Having worked closely with people who attempted suicide, [are] contemplating suicide and with families in the aftermath of suicide in the U.S. — I’m extremely concerned that intervention isn’t being systematically addressed and that I am speaking to counsellors who feel their field is evaporating.

Nathan Fischer lives in Austria. Not currently working as a counselor, he instead sees clients as a self-employed coach and took a full-time job teaching English to make ends meet. Fischer earned his master’s degree in counseling in the United States, and he and his wife will be returning stateside this summer, when he will work toward his counselor licensure and begin a doctoral program.

How did you land in Austria?

I moved to Austria in May of 2010, right after graduating with my master’s degree in counseling. I was born in St. Louis, but I moved to New Orleans as a child and grew up there. I also completed my studies there. I came to Austria to get married. My wife is originally from Austria, but she studied at the University of New Orleans and lived there for many years. We met in New Orleans in 2007, and shortly thereafter, she got her dream job offered to her back home in Austria. Since I was still in my graduate program at the time and didn’t really have a career as yet, I figured I wouldn’t be giving up a whole lot in the career field if I moved to Austria. I also didn’t want my then-girlfriend to have to choose between me and her dream job. So we decided to move. Plus, I thought I would be able to secure a school counseling job at the same school where my wife was employed as a Spanish teacher. After a series of interviews where I was promised the job, we thought it would all work out. The job fell through as soon as I moved over here though. As you can imagine, it was a rough time.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

If I use the word “counselor,” I get a puzzled-looking face and people ask, “What’s that?” Most people I have come across in Austria are unfamiliar with the term “counseling.” There is also no exact translation of the word in the German language. The closest translation I have come across is the word “berater”— which means advisor or consultant — and German speakers in professional and academic circles simply use the English word. If I want people to understand what I do, I say that I am a “psychotherepeut,” or psychotherapist. While not exactly true, this isn’t such a bad compromise because the work of psychotherapists and counselors is not so far apart. However, there is a subtle distinction that is well-defined in the U.S. and is also understood by the majority of the public…not so here in Austria.

That being said, the concept of counseling is really the concept of psychotherapy and carries the same connotation here as it did several decades ago in the U.S. People I have talked to seem to think that only people with major psychological problems or people who are dangerous see these kinds of professionals. In my experience, the Austrian people are very friendly but also very private. Of course, I can only speak of my impressions, but I cannot imagine the typical Austrian seeking the help of a professional because of problems in a relationship or family… unless forced by the authorities. I believe this would be too embarrassing to most people, as well as an admission that they have failed in some way and cannot cope on their own.

This is a country located in the dead center of Europe, and as a result, they have been caught in the center of power struggles for centuries. More recently, the country has weathered two world wars and a holocaust, the latter being no small source of global shame. I truly believe that these world events have shaped the culture and mindset here into one not so open to exposing and looking at failures in general.

What is the role and function of a counselor in your country — why and when do clients go to see one?

I only know one Austrian who regularly sees a psychotherapist. This person has battled depression for the majority of their life and seeks help with that. Incidentally, I have heard about the work they have done together and, in my opinion, the therapist seems to be working from rather outdated perspectives of change and healing.

There is one fascinating anomaly I have come across here. The culture here places an extremely high value on productivity and hard work. As such, the phenomenon of “burnout” has become quite widespread and has drawn the attention of both the public and employers alike. There are actually public awareness campaigns (billboards and TV ads) and worker assistance programs in place to combat burnout. This is one area where I do see a lot of movement towards professional help. Although, the professionals dealing with this are more like life coaches/trainers than professional counselors/psychotherapists. Again, I would say that the distinctions are not readily recognized by the average person.

What would you most want someone reading this article to know about counseling in your country?

Establishing yourself as the same kind of professional as would be in the U.S. seems to be about establishing your authority. Austria has made a science out of bureaucracy and establishing your credentials is a tedious, lengthy and expensive process, one which I still have been unable to fully complete. If you plan to work here as a counselor, you will need to come with the correct paperwork and go through the proper channels. In short, do your research first!

Secondly, of course, is the language barrier. I came to Austria expecting to get a job in an English-speaking school as a school counselor. When that job fell through, I was left seeking other employment. Obviously, counseling is a speaking profession…we talk to our clients. Not only do we talk, we must have a real command of the language in which we counsel. My German has come a long way in the last three years, but I still do not feel confident enough to discuss a client’s inner world in German.

What obstacles does the profession of counseling face in your country?

I would say the biggest obstacle is cultural perception of how change happens and the meaning of asking for help. Counselors are in the business of helping people to change various aspects of their lives. In the past three years, it has been my experience that when the average Austrian seeks to change something in their life, they mostly struggle on their own. They are not inclined to seek the help of a professional. This is a proud, strong, resilient and hardworking culture with many wonderful qualities. I only wish I could do more to educate people here about the benefits of reaching out to a counselor and how much it really helps people to improve the quality of their lives and relationships.

Erik Mansager lives in Switzerland. He and his professional and life partner, Jane Pfefferlé, run a private practice with offices in Geneva and Morges. Mansager works exclusively with the expatriated English-speaking community, while his partner works with that population as well as the native French-speaking community.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

In Switzerland, the word “counselor” (with two L’s) is a protected word. In its German (“berater”), French (“conseiller”) and Italian versions (“consigliere”) and in English (with one L), it is understood simply as “advisor.” This is used in many professional and non-professional settings so there is currently a strong effort to educate the public as to the professional understanding — as we have in the States.

What is the role and function of a counselor in your country — why and when do clients go to see one?

There has just been a major legal decision on behalf of counsellors who had petitioned the federal government to be granted the privilege of earning a federal diploma, which is necessary for federal recognition of the profession’s standing. This was granted over the objection of the Swiss psychological society. Because the counsellor-exam application addresses our focus on providing psycho-social psychotherapy — by which they mean adjustment to traumatic instances and stressful life situations.

The psychologists objected on several accounts: that counsellors would take away their business; that the name and objective of providing psychotherapy would be confusing to the public; and that counsellors were not trained in treating psychopathology. The court struck down the complaint, observing that the market would take care of the business angle; other new professions come and go without confusion to the public that education can’t address; and the counsellor application already noted that severe psychopathology would always be referred to appropriate helping professionals.

This was a major win for our profession here. Promoting its outcome, designing the exam and proffering it are the immediate tasks in front of us.

What lesson or idea from your country would you share with counselors in the U.S. — in what way could counseling in the U.S. benefit from the way counseling is in your country?

Counselling here in Switzerland has a long history — arising from the applied psychology traditions. This is the field in which pastors, nurses, midwives and others were trained — beyond their first profession — to provide for the mental health of their patients and clients. This tradition grew up beside the psychology profession, which was developing so vigorously at the Burghölzi in Zürich. This was not only the home of Jung’s analytic psychology but Karl Abraham’s interest in Freud’s psychoanalysis and, via Alexander Müller, Adler’s individual psychology. As a result of this tradition, counsellors more regularly have had in-depth training in a particular school of psychotherapy — and along with this, there is a tradition of receiving training-analysis in some fashion. My experience is that this lends simultaneously a cohesiveness and gravity to the profession that might not be as obvious in the States. Besides the big three just mentioned, the client-centered approach, transactional analysis and gestalt therapy are also utilized for this training and later as the methodology of counselling applied.

And vice versa, what would you like to see counseling in your country absorb from the way counseling is done in the US?

Although it was also a long struggle in the U.S., it would be nice if the helping professions could cooperate here as the U.S. professions do more and more nowadays. Here, social workers and psychologists seem quite protectionist and worse still, exclusive. It tends to be the case that if you don’t have a Swiss psychological education (or its strict equivalency), you are not welcomed to practice here.

What obstacles does the profession of counseling face in your country?

While we have been given professional recognition and have been granted diploma authorization, it will remain an uphill struggle for insurance coverage. This will take time, but is likely inevitably going to happen.

How do you hope to see the counseling profession evolve in your country?

It will be most helpful if our small and growing organization continues to ally itself with the larger counselling groups here in Europe. Both the European Counselling Association and the ACA’s European Branch are available to us, and we have fledgling contact with them. Uniting is a strengthening factor and would be most welcomed. I hope that we will remain focused on our professional development and service delivery, without ourselves becoming protectionist as our portion of “the helping profession” continues to evolve to serve the needs of the community.

Tolga Nasuh Aran lives and works in Izmir, Turkey. He graduated from the Middle East Technical University Guidance and Counseling Program and has been working as a counselor since 1997. He works as a rehabilitation and family counselor with high-risk families, including those with children who are autistic. He is the president of the Turkish Counseling and Guidance Association of Izmir Regional Branch and the co-president of the Turkish Marriage and Family Counselors Association.

Where has counseling come from over the past decade in your country and where do you see it headed in the next decade?

There are many signs of progress visible in Turkish counseling today. In short, there are questions concerning the roles and functions of counselors, as well as the credentials required to be a counselor, that remain unanswered today. As a result, the counseling profession in Turkey, as in many countries, still seems to be in search of a professional identity of its own.

What would you most want someone reading this article to know about counseling in your country?

There is a lack of uniformity and consistency in counselor education programs among universities. In addition to the lack of consistency among curricula, there is no accreditation system for either undergraduate or graduate counseling programs.

How do you hope to see the counseling profession evolve in your country?

I hope to see my unique profession, counseling, developed likewise [as] U.S.A. in its own unique way. First of all, as practitioners, when we are studying counseling, our professors must be allowed to work in private or public counseling centers. And then, we need our professional organization to be more politically powerful. The Turkish Psychological Counseling and Guidance Association (TPCGA) should be expanded with its subdivisions and regional branches. [Similarly to] ACA, TPGCA should be like an umbrella: School Counselors Association, Marriage and Family Counselors Association, Rehabilitation Counselors Association, Mental Health Counselors Association, Carrier Counselors Association and Association for Counselor Education and Supervision could be established under TPGCA. In universities’ counseling programs will be undergraduate degrees, but subfields of counseling should have graduate programs (M.S., Ph.D.).

To develop our profession, we have to promote people, potential clients, solidarity with international counseling associations, use mass media very well, etc. Twenty years later, Turkish population will not have young population as it has now. People will be older, and rather than school counseling, people need counseling in different fields. We have to plan our profession according to future. The most important and necessary movement will be the approval of professional counseling. We have to make the laws for our profession. We have to build an organisation like NBCC and CACREP. A counselor should finish the supervision. After supervision, the council should approve the license. Thus a counselor can work with license. Graduate programs must be opened not only for researchers but also practitioners. There should be a core programme in counseling in all universities. This must be approved by the council.

Helena Ng lives in Macau. She works in private practice in both Macau and Hong Kong and also works as an assistant professor at a university in Macau. In addition to teaching, she manages the university’s counseling service and supervises counseling students in their clinical work.

If you introduce yourself as a counselor to someone on the street, what does that mean to them?

I have not conducted or read any study on this, however, from my encounter with and observations of people here, I imagine that some people would frown, not knowing what that (such an introduction) might mean. Others might smile and go away, probably would not want to be involved in anything related to counseling. Yet I believe that there some people may show genuine interest or curiosity about something I am going to tell them.

What is the concept of counseling in your country?

In Hong Kong, the concept of counseling is attached to a stigma — only crazy people would seek counseling. I heard many people describing counseling as “talking with someone.” It seems acceptable to them that they are “talking with someone” rather than receiving counseling. In my experience with clients coming from different backgrounds, I notice that people who have received more education seem to support the idea of counseling. There are some people who “appear” to be familiar with the concept of counseling. These people are eager to refer their relatives and friends to the counselor. Yet when they are asked to see a counselor, they would say that they are fine. Then there are some faith believers who seem to be confused about the concept of counseling and spiritual direction. For instance, many people talk about their emotional issues when they meet with their spiritual director.

On the whole, the concept of counseling is associated with something negative. Most people would not see a counselor merely because they want to gain clarity on something or hear some objective perspectives. Also, it occurs to me that a lot of people in Hong Kong do not consider counseling as a proactive means. For example, we often hear that people who have experienced trauma are asked to receive counseling. Perhaps pre-marital counseling service offered by many Christian church organizations is the only service that promotes counseling as a proactive means. This counseling service borrows a psychoeducational approach to prepare couples to live harmoniously as husband and wife.

In Macau, the situation is slightly similar, even though people here seem to be less familiar with the concept of counseling. People perceive social work as a major helping source and counseling is merely a component that supports social workers’ task. Generally speaking, people in Macau are less willing to pay a high fee for counseling service.

What is the role and function of a counselor in your country — why and when do clients go to see one?

In Hong Kong and Macau, counselors play the roles of a mentor, teacher, consultant and advisor. Quite commonly, people seek counseling because someone tells them to. I have a number of children, teenagers and adolescents as clients; all of them come to see me because their parent or parents asked them to. For couples, in general, it is the wife who “drags” the husband to come for couples counseling. For families, usually it is the wife or mother who came to see me first and brought their family members to discuss their issues in subsequent sessions.

In primary and secondary schools, students are asked by parents, teachers or principals to see the school counselor or educational psychologist. In most cases, these school children have emotional or behavioral issues and are asked to see a professional in the school premises.

In colleges and higher educational institutions, some students see the counselor for career guidance. There are very few students who would approach a counselor for their personal or emotional problems. Some educational institutions’ student affairs department may refer students to meet with the counselor on campus.

What would you most want someone reading this article to know about counseling in your country?

I hope that readers will get some information they rarely find in counseling textbooks. First, I would want readers to know that people in Hong Kong and Macau are not completely ignorant about or unfamiliar with the concept of counseling. There are people seeking counseling in Hong Kong and Macau for some years. Some of the users of counseling service may not know what exactly counseling is about, however, they somehow see that their life has been improved after they received therapy.

Second, the identity of counseling is very weak. How can it not be weak? There is no pure counseling program here that is offered by major higher educational institutions. I think it is important that people receive proper education about counseling, its potential benefits and the ways counseling can be offered.

Third, the credentials and standards of providers can be quite diverse as a result of the lack of requirement to obtain license or certificate to practice. It is crucial that the profession establishes an agreed set of ethical standards to guide ethical behaviors of professional counselors.

Finally, the demand for counseling is apparent, but it seems that such demand is still not being “heard.” The reasons behind this situation is possibly due to the weak identity of counseling; the stigma or negative connotation attached to counseling; the lack of empirical data to support the effectiveness of counseling; and the absence of pertinent publicity of counseling service.

How do you hope to see the counseling profession evolve in your country?

I would hope that the following scenarios could be realized eventually:

Formation of a pure counseling program at higher educational institutions

Founding of an Asian branch of the CACREP

Collaboration among individual counseling associations in Hong Kong, Macau and other Asian countries with the ACA

Publishing of more counseling-related research work

Instituting more counseling centers

Educating the public about the concept of counseling

Rachel Erhard is a senior faculty member in the School of Education at Tel Aviv University in Israel. She is a past chair of the master’s graduate program in counseling and past chair of development and research in the Psychological and Counseling Services in Israel. She is currently writing a book called School Counseling: A Profession in Search of Identity.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

The evolution of school counseling in Israel grew out of ideological and social legislation. In a young country, which was absorbing many immigrants (in April we celebrated our 65th birthday), there were gaps in the social fabric between the more established citizens and its newcomers. There were differences of culture and approaches to modern society, as compared to some of the immigrants from Africa and Asia. As such, there was a desire to decrease the gaps and to provide equal opportunities to all students. Counseling began in the 1960s as a way to increase social mobility and desegregated learning environments to students from low social groups.

The evolution of school counseling in the U.S.A. and in Israel is actually quite similar. Both evolved from a vocational/educational model. Today in Israel, there is less focus on the vocational guidance and more emphasis on social-emotional development of the students.

What is the role and function of a counselor in your country — why and when do clients go to see one?

In Israel, school counselors must be certified teachers. The role of school counselor is a vital position in Israeli schools. As counselors are also educators, they are an integral part of the school faculty. Counselors are peers/colleagues of the classroom teachers and are seen as valuable resources for assistance in managing student challenges or difficult situations. Counselors provide training and professional development to teachers and other school personnel with respect to many subjects. Counselors are also valuable resources to parents and community members with respect to student achievement and performance in schools. As the academic and social/emotional supports, school counselors are seen as invaluable sources of guidance to students, parents and educators in schools. What seems to be a guiding principal is that the adult/educator closest to the student should be the one to provide the student with the needed support. As such, very often, the classroom teachers turn to school counselors for advice or suggestions as to how to handle situations in Israeli schools.

School counselors in Israel can be accessed in a variety of ways. Firstly, students can approach a counselor on their own. Counselors try to make themselves available as much as possible to students. Students who may not seek out a counselor on their own may be referred by a classroom teacher or administrator if there is a concern. Parents also approach often the counselor. Sometimes counselors, through their work as educators in the classrooms, will determine that a particular student is in need of support, or students may approach a teacher due to their exposure/familiarity with the counselor through their classroom experience.

What would you most want someone reading this article to know about counseling in your country?

One thing that stands out in school counseling in Israel is its constant growth and the spread of counseling across many facets of the education system. More and more — endless — issues are perceived as the counselor’s role. The good news is that school counseling is seen as an integral part of the Israeli education system. The difficulty is that school counselors have in addition to the traditional roles more and more professional responsibilities (sexual harassment, learning disabilities, crisis interventions, children of divorced families and more and more) without receiving additional time resources (hours) in their contract to complete all of the tasks at hand.

One of the biggest changes in school counseling in Israel is the shift from individual counseling to more of a systemic model. For example, two key areas of focus is the intensive involvement of the counselors in enhancing positive social-learning school climate and preventing school violence, bullying and harassment. Counselors are also trying to really focus on the wellbeing of students and prevention initiatives. There is a curriculum for K-12 called Life Skills, which counselors use in the training of prevention. That being said, very often, counselors find themselves in roles [that] are less preventative and more reactive, due to their ever-growing list of responsibilities. As such, counselors are moving from individual counseling to more of a consultative role with classroom teachers, parents, faculty/staff and administrators.

How do you hope to see the counseling profession evolve in your country?

In the next decade, I would hope that there would be more focus and emphasis on the unique identity of the role of school counselor. And on the other hand, being pragmatic and realistic, counselors will have to be able to be flexible and be relevant and adaptive, based on the rapid changes in policy and evolving nature of education. For example, the use of social media as a means for cyberbullying and harassment is truly horrific. On the other hand, how will counselors be able to effectively use and mediate the use of technology in school counseling?

I think the second thing to focus on in our two countries is the concept of social justice and school counseling. Poverty is on the increase and the gaps between students continue to grow. As school counselors, we will have to learn how to recognize and use our roles proactively to promote opportunities for underrepresented populations in education that might not be afforded in other social service arenas.

On one hand, we can learn from the U.S.A. on how to delineate and stay true to the more formal and theoretical approach to counseling. However, we should also keep our perspectives and approaches as inclusive and as broad as possible so as to include the larger social network and community.

Arleen Swan works as an “adjustment counsellor” at a secondary school in Bermuda, where she provides mental health counseling and support services to students in grades nine through 12. She has worked as a school counselor in Bermuda for 24 years.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

Counsellors, in Bermuda, have become an integral body of professionals providing a variety of services and resources. The largest setting of employment for counsellors is in the school setting. Since approximately 1995, we have seen counsellors placed in every level of the Bermuda government educational system: pre-school, primary, middle and senior school.

In general, the Bermuda community does have a basic knowledge and understanding of a counsellor’s role, function and services rendered. As I speak specifically to the role of school counselors, most people view them as assisting with specific academic, social/emotional, mental health, behavioral and parenting challenges. There are mixed reviews about how the other educational professionals and parents/guardians view counsellors. The thought is that we “fix problems” and have untold powers unbeknown to ourselves to do miraculous (quick-fix) work.

Having said [that], for the most part, counsellors’ work is valued as they have become essential professions on [the] island.

What is the role and function of a counselor in your country — why and when do clients go to see one?

Counsellors work in a variety of settings in Bermuda. As previously mentioned, the Bermuda education system is one of the largest employers. However, there are counsellors in mental health settings in Bermuda, along with private practitioners and in the employee assistance programs.

Clients can seek counselling services for a variety of reasons similar [to] that of persons accessing counselling services in the U.S.A.

Where has counseling come from over the past decade in your country and where do you see it headed in the next decade?

Professional counsellors working in Bermuda, in general, have received their master’s education and designation from an accredited institution in the U.S.A., Canada or the United Kingdom. There are some who are members of the ACA and/or local BCA (Bermuda Counsellors Association with affiliation with APCO & ACA).

The Bermuda Health Council, under the auspices of the Ministry of Health and supported by the Bermuda Counsellors Association, [is] looking to establish legislation on the registration and regulations of counsellors and other mental health professionals working in Bermuda.

Gilberto Salinas is an assistant professor of psychology and clinical director of the Department of Student Counseling and Disability Services at Texas A&M International University in Laredo, Texas, just across the border from Nuevo Laredo, Mexico. Salinas, who also has a small private practice, has done counseling work in Nuevo Laredo, but not since 2007 due to violence associated with the drug cartels. He works with many people from Mexico who have been displaced or have come across the border and sought counseling help.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

Sadly, the general Mexican populace believes that a counselor is a “loquero,” someone who works with “crazy people.” Those who do seek services generally have the expectation that the counselor will give them advice and answer their questions. However, once the concept of psychotherapy is understood, they embrace it and tend to be faithful.

Where has counseling come from over the past decade in your country and where do you see it headed in the next decade?

People still hold on to “familismo” and tend to keep things in the family. Nevertheless, the stigma of seeking professional services outside of the family unit or the church appears to be slowly decreasing, especially among the college-age individuals. Theoretically, counseling in Mexico historically has been very Freudian; nevertheless, more theories have been gaining favor, such as Gestalt and person-centered lately. I believe there will be a proliferation of diverse theoretical practices in the future decades. Because of the years of drug cartel violence, I see Mexico as a crucible for development and consumption of trauma-focused approaches to therapy.

What would you most want someone reading this article to know about counseling in your country?

In Mexico, there is a wide field for research and service in this country for serving the severely traumatized population because of the cartel violence. In the U.S., there is urgent need for counselors who speak Spanish and are well-versed in the Mexican culture to serve the displaced affluent Mexicans who are legally migrating to the U.S.

Amandi Mboya works as a community counselor with the Ruben Centre, a faith-based organization in Nairobi, Kenya. Mboya, who graduated from Fordham University’s Graduate School of Religion and Religious Education, works with preadolescent boys and girls, offering crisis intervention, ongoing support and life-skills activities.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

The concept of counseling in Kenya is widely understood to both young and old generation in the city where I am based. I have no statistics on how widely counseling is understood [across the country]. Professional counseling is well known in the city areas where majority of the elite lives. Most of my clients are poor people who can not avoid to pay a trained counselor. Some have never attended counseling before, others never heard or not sure what is the role of a counselor.

What is the role and function of a counselor in your country — why and when do clients go to see one?

The role and function of a counselor in my experience is that of a teacher, someone who knows and understand another person’s struggles, whether intrinsic or extrinsic issues. His or her role is to guide the one seeking help toward some kind of healing or better coping with the situation.

Where has counseling come from over the past decade in your country and where do you see it headed in the next decade?

Traditional counseling has been in existence for years; on the other hand, professional counseling is a new concept that is gaining ground with most people. Probably, the emerging of HIV/AIDS pandemic has speed up the professional counseling concept. Professional counseling is here to stay.

What would you most want someone reading this article to know about counseling in your country?

I would like the readers to delete a concept that counseling is a Western concept. It is a universal need, only in Western [cultures], things are more structured, documented and strong ethical and legal.

I worked in America as an intern, before coming back to Africa. Most people are paid for their service. My experiences in Keya so far, counselors are volunteers who are willing to support others in their daily struggles.

Grazia Di Giorgio is a counselor in private practice in Bari, Italy. She also sees some counseling clients and provides some clinical supervision via Skype.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

I came back to live in the South of Italy only a little over a year ago after having trained and worked as a counselor in the U.S. from 2000 to 2011. Since coming back, I have had a lot of practice in explaining what I do and what counseling is in this country, so this is a particularly interesting question for me…

I will begin with the second part of the question and say that in general, so far, I have met only a few people in Italy who seem to already know something about counseling. On the other hand, for the most part, people seem quite curious about it, and I have received many excellent client referrals from friends and acquaintances just on the basis of casual conversations about my counseling and “somatic experiencing” work.

Aside from reflecting a still very strong cultural stigma against mental illness and the predominance of classic psychoanalytic tradition and of the “medical mode” over the entire field of psychology in Italy (a situation that seems comparable to the one in the U.S. not too long ago), this ignorance about counseling can be partly explained by the fact that although there are several counselor training programs active in Italy at this point, the profession was still entirely unregulated until a controversial law was passed only a couple of months ago. In fact, the concept of counseling here seems to be profoundly marked by a very conflictual relationship between the psychologists and the counselors, with psychologists revindicating the exclusive right to a professional status and exclusive access to the title of psychotherapists, while at the same time pushing for a very restrictive definition of the activities and the areas of competence and intervention allowed to a counselor.

In spite, or perhaps precisely as a result of this state of things, I have found that people’s interest and hopes for engaging in this work seem almost always enlivened by my explanation that a counselor — unlike a psychologist — works on a more egalitarian basis with her clients, that s/he is trained to use specific techniques in order to work on specific issues or problems defined and agreed upon collaboratively with the clients, and that we are limited to a rather small number of sessions, usually also agreed upon at the beginning.

Many people seem quite excited to hear this and to understand that counseling does not work with what for them is the “classical” medical model based on the idea of pathology and operating within the hierarchical structure of a doctor-to-patient relationship. Instead, I explain that my job consists mainly of supporting self-awareness, offering some relevant information, providing containment and ultimately fostering the person’s own resources and sense of agency.

The current Italian law requires me to tell any prospective client that as a counselor I am prohibited from working long term with anyone or with people with more serious and/or chronic mental health issues. I will confess, especially given the extensive and excellent clinical experience and training that I have accumulated in the U.S., that I see this rule as an unfair limitation of my scope of practice, but at the same time, this statement often has turned into a point of interest for my interlocutors when I treated it as an opportunity to emphasize by contrast the profoundly creative and empowering perspective that counseling offers to anyone who, rather than seeing themselves as a mentally ill patient in need of a diagnosis and medical treatment, might choose of their own accord to explore new ways and possibilities to live her or his life in a fuller or more satisfying way.

What is the role and function of a counselor in your country — why and when do clients go to see one?

I think that I already partly answered this question in my response to the previous one. As I have mentioned, the role of a counselor in Italy is starkly separated from that of the psychologist or the psychotherapist. As such, we are required to clarify for each prospective client that we do not provide medical or psychological cures and that counseling sessions don’t have a diagnostic or a therapeutic function, which is instead reserved for the psychologist, the psychotherapist, the doctor or the psychiatrist. Except then for those of us who are also comprised in one of these latter categories, counselors here have only a very marginal role — if one at all — as consultants or service providers within public and/or private organizations, but for the most part, we seem to operate out of a private office or within a counseling training program.

Because of this limiting definition of our area of expertise (which of course ends up having a detrimental impact on the training standards and the competence levels of the counselors who train and practice here), I would say that people who come to see a counselor in Italy must generally be at a rather high level of functioning. Often, I would say that people are motivated to begin this work by an interest in the specific technique or model that the counselor is trained in (for example whether the counselor works with family constellations, neuro-linguistic programming, art, movement, etc.) So far, almost all of my clients in Italy have come to see me because they were interested in trying somatic experiencing work, which is an approach to traumawork and neuro-rehabilitation originally developed in the U.S. by Peter Levine. This powerful work is still pretty much completely unknown here, and, in spite of its overtly therapeutic agenda, it can be legally practiced in Italy with the title of counselor.

What obstacles does the profession of counseling face in your country?

In short, I would say that the obstacles for Italian counselors mostly seem to revolve around the cultural stigma and the lack of information and awareness around mental health-related issues, as well as the heavy credentialing/scope-of-practice limitations currently imposed on our professional category.

Raymond Cheong lives and works in Singapore and is a third-generation Singaporean. He is a clinical child/youth counselor and operates a learning/counseling clinic that handles academic, social and emotional learning issues among children.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

Counselling in Asia is a taboo word, hence we combine learning and counselling to create a holistic place for the children and parents to come for learning counselling. Children and youth learning difficulties, apart from physiological deficiencies, social and emotional deficiencies, can cause them to do badly in learning academically and with learning about people, things and matters. Inevitably, anti-social behavioural issues surface. Combining counselling and learning is our mode of operation here in Singapore.

In Asia, it is not common that an adult go for counselling, although they know the importance of it. It has to do with the misunderstanding that if you were to visit a counselor you have an issue and hence you are not normal. Asians live in a very judgmental society basically.

They will usually respect me as a counsellor and will associate me with children and youth more than adults. Usually when a child is in trouble, it is not common to see parents admitting they are at fault to a certain or large extent. It is always the child’s issue and no one else…hence only the child needs counselling.

Where has counseling come from over the past decade in your country and where do you see it headed in the next decade?

Over the past decade, I have observed counselling practise moving up the professional ladder here in Singapore with more awareness from the public about the importance of counselling. I trust with more regulatory control, we can make counselling a profession that is more respected by the mainstream as a holistic way to seek human mental, learning and perspective help without the use of medication and reckless classification of people into disadvantage learning spectrums out of convenience by other professionals.

How do you hope to see the counseling profession evolve in your country?

I hope to see more mid-life career change individuals step into the profession to help others. However, they should learn from the basic rather than leveraging on previous higher qualification to study a master degree in counselling psychology … They should learn from a diploma onwards to understand more about the micro skills in counselling instead of just plucking themselves into a master degree program. Counselling knowledge from academic [pursuit] cannot be directly applied with a qualification certification.

Huguette Ostiguy is from Canada but has been working in Malawi since 1979. Ostiguy works for the St. John of God Community Services, teaching at St. John of God the College of Health Sciences, which offers a two-year counseling training.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

Here in Malawi, the work [of] “counselling” came with the recognition of the reality of HIV and AIDS in the early 1980s when the Ministry of Health introduced the HIV Testing and Counselling (HTC). So the work [of] counselling has been and still is strongly connected to that, as there are HTC sites all over the country. So for people, [counselling] mainly means to be tested for HIV and to be explained about risky behaviour or to avoid getting infected, etc. It is now offered to clinics of pregnant mothers so to know their HIV status and so to take measures to avoid transmission to the baby. With the development of a more professional training in psychosocial counselling — to underline the difference with HTC — slowly the word counselling in taking a new meaning.

What is the role and function of a counselor in your country — why and when do clients go to see one?

Beside the Psychosocial Counselling Services offered at St. John of God Community Services, Mzuzu, where people come spontaneously for assistance, there is no other such service yet. Slowly, other people are now getting trained mainly in Kenya or Uganda, and that also is starting to contribute to the counselling services reaching to people mainly in faith-based organisations and churches.

Where has counseling come from over the past decade in your country and where do you see it headed in the next decade?

See the description above for the past. For the future, professional, therapeutic, psychosocial counselling is moving ahead. Training will continue at St. John of God College of Health Sciences, and other theoretical courses, as well as short programmes, are given and will continue to be offered by different stakeholders.

What would you most want someone reading this article to know about counseling in your country?

Professional trained counsellors are much needed to offer assistance to people and to support the training. Nothing resembles more a human being [than] another human being. We all have the same psycho-emotional needs, the same pain and the same desire for freedom. Up to now, counselling is not yet recognized as a profession in Malawi, and so it not yet included in the establishment of services, even in the Ministry of Health, neither in Ministry of Education, etc. This is a challenge for us to move this forward and to get one day the official recognition by the government of Malawi of counselling as a profession and for the counsellors their rightful place among the professionals offering services for the well-being of the people of Malawi.

Usha Nair is from Singapore and worked there as a counselor until 2007, when her husband was posted to Mumbai, India. Nair obtained a job as a counselor with a local airline in Mumbai in 2010. She works with airline staff members who, stationed away from their homes, cope with work-related stress and being away from their families.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

Most people respect the profession, aware that it requires a college degree and practical training. They do not differentiate between counselors and psychologists. Many think it is an interesting job, especially since counselors are privy to others’ personal issues/struggles. However, most Indians also believe that only the “mentally ill” or those “unable to handle issues on their own” seek counseling. Hence, there is a stigma attached to seeking professional help.

What is the role and function of a counselor in your country — why and when do clients go to see one?

These would depend on the setting in which the counselor operates — in schools, hospitals, organizations or when mandated by the courts, etc. Being a society that values family and community cohesion, most Indians prefer to resolve their issues within these groups and only seek professional help as a final resort. However, younger Indians are more receptive to counseling because many had counselors in school or college. Hence, they pay less heed to the stigma.

Where has counseling come from over the past decade in your country and where do you see it headed in the next decade?

Having been here for only about three years, I am unable to comment accurately on how counseling has evolved in India. However, the younger generation of Indians is more receptive to counseling services due to awareness and exposure at school, college and in some workplaces. With a rising middle class that is exposed to foreign cultures and practices (through travel, television and the Internet), I believe seeking professional counseling will carry less stigma and be more accepted in the future.

What would you most want someone reading this article to know about counseling in your country?

It is important to be aware of, and sensitive to, the client’s history and background, especially in the areas of culture and traditions. India has a huge population and diverse religions, traditions, cultures and beliefs. There is also a wide gap between the have and have-nots.

What lesson or idea from your country would you share with counselors in the U.S. — in what way could counseling in the U.S. benefit from the way counseling is in your country?

Most people in India have a strong belief in destiny/fate. While this sometimes leads to apathy in resolving personal issues, it also increases their patience and tolerance for frustrations/suffering. Rather than rely heavily on “textbook” counseling techniques or focus on which theory/approach to adopt for clients, it sometimes helps to explore and reinforce the client’s spirit — through active listening, encouragement, positive thinking and where appropriate, humor. Also, I feel U.S. counselors may be somewhat generous in dispensing “positive regard” to one and all; I think it is alright occasionally to have a client “earn” it.

And vice versa, what would you like to see counseling in your country absorb from the way counseling is done in the U.S.?

From my experience, many clients here, upon seeking professional help, expect the counselor to solve their issues for them or offer solutions and answers within one or two sessions. They are somewhat reluctant (or lazy) to do “homework” or explore options before taking a decision to improve their situation. Counseling here would benefit from the practice of encouraging clients to be proactive in their own healing and empowerment, rather than focus on solutions [solely from the counselor].

What obstacles does the profession of counseling face in your country?

I believe only a few universities in India offer psychology courses with counseling as a major. Hence, counselors may be adept in the science of psychology but not as competent in the art of counseling. Attending foreign universities is a very costly undertaking for the average Indian. Also, counselors (especially in private practice) may not get many clients, given the stigma attached to seeking professional help. This may turn young people away from the profession, which in turn reinforces fewer universities offering the course.

How do you hope to see the counseling profession evolve in your country?

Counselors can help their clients (and the public) to view their service as yet another avenue to achieve wellness. Stakeholders (government, healthcare institutions, schools, NGOs, etc.) need to work together to improve infrastructure and increase funds so that this service is available to all who need it or can benefit from it. They can also dispel the negative image of mental illness through education and outreach programs.

Gudbjörg Vilhjálmsdóttir is a professor in a two-year master’s program in career guidance and counseling at the University of Iceland. She has been teaching there since the counselor education program began in 1990.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

I discussed this question with my first-year students and they said that often people do not know what they are talking about when they say they are studying to become counselors. Ten to 20 years ago, that was certainly often the answer I got, but today my experience is that counselors have a positive image because everyone has career problems, [and] this was something many of my students also related to. They said that the profession of counselor is considered respectful “because all the counselors I know are ambitious and genuine people,” to quote an email from one of my students. My experience also tells me that the image of counselors is positive since all my students who have graduated from our program get counselor positions, at least those who want to pursue that career path. About 300 students have received a one-year diploma, and thereof, about 80 have pursued their studies to a master’s degree. The master’s degree was optional from 2004 to 2010 but is now the only educational program available.

What is the role and function of a counselor in your country? Why and when do clients go to see one?

Here I can cite a study that tells us that nearly 60 percent of school counselors’ time is devoted to personal counseling. Another study on adult guidance tells us that by far the most used counseling method is face-to-face counseling. The counselor/student ratio can vary from 1/200 to 1/2000, so accordingly, the roles vary. I would therefore say that their role is rather traditional, at least in schools.

Where has counseling come from over the past decade in your country and where do you see it headed in the next decade?

Counseling is changing fast. In 2008, we had a legislation that said that all students should have a right to counseling. The counseling profession was licensured in 2009. [Since] the 2008 [economic] crisis, adult counselors have been very active in creating innovative and very successful interventions to the unemployed. I see counseling in Iceland heading towards a more organized and comprehensive program that has less emphasis on personal counseling and more emphasis on career counseling and career education. For the moment, I would like us to have a more common vision, and fortunately, there is a growing emphasis on policy-making at the ministry of education.

What would you most want someone reading this article to know about counseling in your country?

I would like you to know that counselors that work at all school levels, in adult education centers and employment offices are all trained in the same program. Of course, the reason is that the population of the country is small, but it means that counselors speak the same professional language, they shift positions from working with children and then adults and vice versa. I would also like you folks out there to know that if it wasn’t for international associations like American Counseling Association or the International Association for Educational and Vocational Guidance, as well as the Nordic associations of counselors, we here in Iceland would not have progressed as real professionals. International cooperation is vital for us.

What lesson or idea from your country would you share with counselors in the U.S.? In what way could counseling in the U.S. benefit from the way counseling is in your country?

I am aware of the fact that Iceland is a tiny country compared to the U.S. But the successful programs that were implemented in the wake of the 2008 crisis for young unemployed, for adults that lost their work in the financial sector, for older unemployed and, now recently, a big intervention targeting those people who have been unemployed for more than three years. These interventions have included the state, municipalities, unions, employers associations, unemployment offices and adult education centers. I think that the underlying idea is that work is highly valued in our culture and somehow it is intolerable that a person has “idle hands” as we say.

And vice versa, what would you like to see counseling in your country absorb from the way counseling is done in the U.S.?

So many things, I cannot but mention a few. Supervision of students, counseling methods, counseling theories, counseling research, strong professional identity, multicultural awareness, a big professional body (ACA), inspiring leaders in your counseling field and more.

What obstacles does the profession of counseling face in your country?

In fact there are only opportunities, the only obstacle is when people in leading positions within the profession don’t see them or do not realize that they have been given opportunities. One of my students said that she would like to see counselors more prominent in our society, that their work was better known. She also said that they need better salaries. I often tell my students that a crisis in a person’s life is made of the

building blocks we use when construing a new vision with our counselees. The key is often that people can see what the crisis is made of and how to redesign a new path in life. I think the obstacle for counseling here in Iceland is when we think that counseling should not change and methods stay the same. Then we are in trouble. Renovation is essential to what we do.

How do you hope to see the counseling profession evolve in your country?

I am now working on creating an integrated web system for the country, which means that I think it is essential to use technology to reach out to everyone in the community. I would like the counseling profession to evolve hand-in-hand with the users of [technology] towards a situation where every citizen can have an easy access to counseling where she and he will learn how to manage her or his career and that the assistance given is well-organized and really helpful. One of my students said that she would like to see this profession more acknowledged in schools, especially from children aged 6 to 16. She also thinks it is absolutely necessary that career education should start at an early age. She would like to see at least one counselor in every school and the counselors’ association start an advertisement campaign that informs people about the professional work of counselors. I agree with her. Counselors need to show their power and make use of it as advocates of their counselees.

Gerardo Alfonso Steele Zúñiga is from Costa Rica, where he runs a private counseling practice in the capital city of San José.

If you introduce yourself as a counselor to someone on the street, what does that mean to them? What is the concept of counseling in your country?

If I introduce myself as a counselor, people immediately ask about its meaning. This is like that because there is not enough knowledge about counseling. It happens that around here counselors work in educational settings: primary, high school or university.

Usually the translation to Spanish of the [word] counseling or counselor concepts is “orientación” or “orientador,” and what people in need of mental [and] emotional help tend to look for is the psychology professional. Thus, counseling, in the people’s mind, has to do with [a] school setting.

What obstacles does the profession of counseling face in your country?

The obstacles for the counseling development in Costa Rica is one of the cultural type, in the sense that what is well established is the psychological thought. I hope it should be a strong evolution in the real sense of counseling.

Looking for more?

The following resources can help counselors get involved in and learn more about international counseling issues.

ACA’s Journal of Counseling & Development features a special international counseling section in each issue.

Counseling Around the World: An International Handbook, edited by Thomas H. Hohenshil, Norman E. Amundson and Spencer G. Niles, and published by ACA. Native counselors and leading experts from 40 countries discuss the opportunities for growth in their countries and the challenges they face (visit the ACA Online Bookstore at counseling.org/publications/bookstore).

In Malawi Professional Counseling is a budding profession…mostly there has been traditional advice giving amongst friends, keens etc. However, if I introduce myself as a Counselor on the street almost everyone would think of me as a HIV Counselor..who conduct HIV diagnosis. This is so because the word counselor sounds too clinical to the point most people associate it with hospital or something like that.